Executive function and mealtime behavior among preschool-aged children born very preterm

Area of Science:

• Pediatric Neurodevelopment
• Child Psychology
• Developmental Pediatrics

Background:

• Very preterm birth (<30 weeks' gestation) is associated with increased risk for neurodevelopmental challenges.
• Executive function, crucial for self-regulation, may be impaired in children born very preterm.
• Problematic mealtime behaviors are common in young children and can impact family dynamics and child well-being.

Purpose of the Study:

• To investigate the association between executive function and problematic mealtime behavior in preschool-aged children born very preterm.
• To identify potential early indicators of mealtime difficulties in this vulnerable population.

Main Methods:

• Assessed executive function in 41 very preterm preschoolers (mean age 47 months) using a standardized "gift bag" task and parent-report (Behavior Rating Inventory of Executive Function-Preschool).
• Evaluated mealtime behavior problems using a parent-reported 20-item index (Meals in Our Household).
• Employed multivariable regression to analyze the relationship between executive function measures and mealtime behavior problems, controlling for relevant covariates.

Main Results:

• A significant correlation was found between parent-reported executive function (BRIEF-P) and mealtime behavior problems (r=0.57, P<0.0001).
• Each 10-unit increase in BRIEF-P executive function score was associated with a 7.2-unit increase in mealtime behavior problems score, even after adjusting for covariates.
• Children demonstrating good executive function on the "gift bag" task had significantly fewer mealtime behavior problems (mean 11.2 vs. 20.8, P=0.02), a finding that persisted after covariate adjustment (P=0.03).

Conclusions:

• Difficulties in executive function are associated with increased mealtime behavior problems in preschool-aged children born very preterm.
• These findings suggest that executive function deficits may underlie some mealtime challenges in this population.
• Further research with larger cohorts is recommended to aid parents in anticipating and managing these behaviors.